Double hit & double expressor lymphomas: a multicenter analysis of survival outcomes with CD19-directed CAR T-cell therapy

Double-hit (DHL) and double expressor (DEL) DLBCL have poor prognosis with standard therapy but CART may overcome this poor prognostic impact. In this multicenter retrospective study, we sought to confirm this observation by evaluating survival outcomes among patients with relapsed/refractory DHL an...

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Published in:Blood cancer journal (New York) Vol. 15; no. 1; pp. 43 - 7
Main Authors: Karmali, Reem, Shouse, Geoffrey, Torka, Pallawi, Moyo, Tamara K., Romancik, Jason, Barta, Stefan K., Bhansali, Rahul, Cohen, Jonathon B., Shah, Nirav N., Zurko, Joanna, Kenkre, Vaishalee P., Hess, Brian, Stephens, Deborah M., Fitzgerald, Lindsey, Ollila, Thomas, Tabiti, Bukky, Roy, Ishan, Ma, Shuo, Winter, Jane, Pro, Barbara, Moreira, Jonathan, Danilov, Alexey V., David, Kevin, Gordon, Leo I., Epperla, Narendranath
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 26.03.2025
Springer Nature B.V
Nature Publishing Group
Subjects:
692/699/1541/1990/291/1621/1915
692/699/67/1059/2325
692/700/565/251
Adult
Aged
Aged, 80 and over
Antigens, CD19 - immunology
Biomedical and Life Sciences
Biomedicine
Cancer Research
Female
Hematology
Humans
Immunotherapy, Adoptive - adverse effects
Immunotherapy, Adoptive - methods
Lymphoma, Large B-Cell, Diffuse - genetics
Lymphoma, Large B-Cell, Diffuse - immunology
Lymphoma, Large B-Cell, Diffuse - mortality
Lymphoma, Large B-Cell, Diffuse - therapy
Male
Medical prognosis
Middle Aged
Oncology
Prognosis
Receptors, Chimeric Antigen
Retrospective Studies
Treatment Outcome
Young Adult
ISSN:2044-5385, 2044-5385
Online Access:Get full text
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Summary:Double-hit (DHL) and double expressor (DEL) DLBCL have poor prognosis with standard therapy but CART may overcome this poor prognostic impact. In this multicenter retrospective study, we sought to confirm this observation by evaluating survival outcomes among patients with relapsed/refractory DHL and DEL treated with CART and evaluate outcomes of relapse post-CART. A total of 408 adult patients with relapsed/refractory DLBCL from 13 academic centers were included based on the availability of DHL and DEL. All 408 patients were included in the DHL ( n  = 80) vs non-DHL ( n  = 328) analysis, while 333 patients were included in the analysis of DHL ( n  = 80) vs DEL ( n  = 74) vs non ( n  = 179). On MVA, there were no differences for PFS for DHL vs non-DHL (HR 0.8, 95%CI 0.5–1.3, p  = 0.35) or DHL vs DEL vs other (three-way p value, p  = 0.5). Response rates and toxicities were similar among groups. Patients with DEL had the highest relapse rates post-CART, while DHL had the worst overall survival after CART relapse. In sum, our data support the notion that CART cell therapy can overcome the poor prognostic impact of DHL and DEL DLBCL in the relapsed/refractory setting. Additionally, patients with DHL that relapse after CART have a very poor prognosis.
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ISSN:2044-5385
2044-5385
DOI:10.1038/s41408-025-01250-8